Head and Neck Diseases by Alexandros G.Sfakianakis: 02/22/17

Τετάρτη 22 Φεβρουαρίου 2017

IFC (editorial board)

Publication date: March 2017
Source:Peptides, Volume 89

http://ift.tt/2mnNdXT

The International Neuropeptide society pages

Publication date: March 2017
Source:Peptides, Volume 89

http://ift.tt/2ma9QTw

Gayle & Richard Olson prize pages

Publication date: March 2017
Source:Peptides, Volume 89

http://ift.tt/2mnJFoC

Glucagon-like peptide-1 (GLP-1) increases in plasma and colon tissue prior to estrus and circulating levels change with increasing age in reproductively competent Wistar rats

Publication date: Available online 22 February 2017
Source:Peptides
Author(s): Michelle L. Johnson, M. Jill Saffrey, Victoria J. Taylor
There is a well-documented association between cyclic changes to food intake and the changing ovarian hormone levels of the reproductive cycle in female mammals. Limited research on appetite-controlling gastrointestinal peptides has taken place in females, simply because regular reproductive changes in steroid hormones present additional experimental factors to account for. This study focussed directly on the roles that gastrointestinal-secreted peptides may have in these reported, naturally occurring, changes to food intake during the rodent estrous cycle and aimed to determine whether peripheral changes occurred in the anorexigenic (appetite-reducing) hormones peptide-YY (PYY) and glucagon-like peptide-1 (GLP-1) in female Wistar rats (32-44 weeks of age). Total forms of each peptide were measured in matched fed and fasted plasma and descending colon tissue samples for each animal during the dark (feeding) phase. PYY concentrations did not significantly change between defined cycle stages, in either plasma or tissue samples. GLP-1 concentrations in fed plasma and descending colon tissue were significantly increased during proestrus, just prior to a significant reduction in fasted stomach contents at estrus, suggesting increased satiety and reduced food intake at this stage of the cycle. Increased proestrus GLP-1 concentrations could contribute to the reported reduction in food intake during estrus and may also have biological importance in providing the optimal nutritional and metabolic environment for gametes at the potential point of conception. Additional analysis of the findings demonstrated significant interactions of ovarian cycle stage and fed/fasted status with age on GLP-1, but not PYY plasma concentrations. Slightly older females had reduced fed plasma GLP-1 suggesting that a relaxation of regulatory control of this incretin hormone may also take place with increasing age in reproductively competent females.

http://ift.tt/2kOVrfi

Long Time No See: Enduring Behavioral and Neuronal Changes in Perceptual Learning of Motion Trajectories 3 Years After Training

<span class="paragraphSection"><div class="boxTitle">Abstract</div>Here, we report on the long-term stability of changes in behavior and brain activity following perceptual learning of conjunctions of simple motion features. Participants were trained for 3 weeks on a visual search task involving the detection of a dot moving in a "v"-shaped target trajectory among inverted "v"-shaped distractor trajectories. The first and last training sessions were carried out during functional magnetic resonance imaging (fMRI). Learning stability was again examined behaviorally and using fMRI 3 years after the end of training. Results show that acquired behavioral improvements were remarkably stable over time and that these changes were specific to trained target and distractor trajectories. A similar pattern was observed on the neuronal level, when the representation of target and distractor stimuli was examined in early retinotopic visual cortex (V1–V3): training enhanced activity for the target relative to the surrounding distractors in the search array and this enhancement persisted after 3 years. However, exchanging target and distractor trajectories abolished both neuronal and behavioral effects, suggesting that training-induced changes in stimulus representation are specific to trained stimulus identities.</span>

http://ift.tt/2kP4Sez

Gβ2 Regulates the Multipolar-Bipolar Transition of Newborn Neurons in the Developing Neocortex

<span class="paragraphSection"><div class="boxTitle">Abstract</div>Proper neuronal migration is critical for the formation of the six-layered neocortex in the mammalian brain. However, the precise control of neuronal migration is not well understood. Heterotrimeric guanine nucleotide binding proteins (G proteins), composed of Gα and Gβγ, transduce signals from G protein-coupled receptors to downstream effectors and play crucial roles in brain development. However, the functions of individual subunits of G proteins in prenatal brain development remain unclear. Here, we report that Gβ2 is expressed in the embryonic neocortex, with abundant expression in the intermediate zone, and is significantly upregulated in differentiated neurons. Perturbation of Gβ2 expression impairs the morphogenetic transformation of migrating neurons from multipolar to bipolar and subsequently delays neuronal migration. Moreover, Gβ2 acts as a scaffold protein to organize the MP1-MEK1-ERK1/2 complex and mediates the phosphorylation of ERK1/2. Importantly, expression of a constitutively active variant of MEK1 rescues the migration defects that are caused by the loss of Gβ2. In conclusion, our findings reveal that Gβ2 regulates proper neuronal migration during neocortex development by activating the ERK1/2 signaling pathway.</span>

http://ift.tt/2meN3Th

Higher Striatal Iron Concentration is Linked to Frontostriatal Underactivation and Poorer Memory in Normal Aging

<span class="paragraphSection"><div class="boxTitle">Abstract</div>In the brain, intracellular iron is essential for cellular metabolism. However, an overload of free iron is toxic, inducing oxidative stress and cell death. Although an increase of striatal iron has been related to atrophy and impaired cognitive performance, the link between elevated iron and altered brain activity in aging remains unexplored. In a sample of 37 younger and older adults, we examined whether higher striatal iron concentration could underlie age-related differences in frontostriatal activity induced by mental imagery of motor and non-motor scenes, and poorer recall of the scenes. Higher striatal iron concentration was linked to underrecruitment of frontostriatal regions regardless of age and striatal volume, the iron-activity association in right putamen being primarily driven by the older adults. In older age, higher striatal iron was related to poorer memory. Altered astrocytic functions could account for the link between brain iron and brain activity, as astrocytes are involved in iron buffering, neurovascular coupling, and synaptic activity. Our preliminary findings, which need to be replicated in a larger sample, suggest a potential frontostriatal target for intervention to counteract negative effects of iron accumulation on brain function and cognition.</span>

http://ift.tt/2kP190D

Neuronal and Peripheral Pentraxins Modify Glutamate Release and may Interact in Blood–Brain Barrier Failure

<span class="paragraphSection"><div class="boxTitle">Abstract</div>Neuronal pentraxin 1 (NPTX1) has been implicated in Alzheimer's disease, being present in and around dystrophic neurons in plaques, affecting glutamatergic transmission postsynaptically and mediating effects of amyloidβ. Here, we confirm the presence of NPTX1 around plaques in postmortem Alzheimer's disease brain and report that acutely applied human NPTX1 increases paired-pulse ratio at mouse CA3-CA1 hippocampal synapses, indicating a decrease in glutamate release. In contrast, chronic exposure to NPTX1, NPTX2, or NPTX receptor decreases paired-pulse ratio, mimicking some of the earliest changes in mice expressing familial Alzheimer's disease genes. The peripheral pentraxin, serum amyloid P component (SAP), causes similar synaptic effects to NPTX1. The presence of SAP on amyloid plaques in Alzheimer's disease confirms that it can enter the brain. We show that SAP and neuronal pentraxins can interact and that SAP can enter the brain if the blood–brain barrier is compromised, suggesting that peripheral pentraxins could affect central synaptic transmission via this interaction, especially in the event of blood–brain barrier breakdown.</span>

http://ift.tt/2meIGrs

Low-Rank and Sparse Decomposition Based Shape Model and Probabilistic Atlas for Automatic Pathological Organ Segmentation

Publication date: Available online 22 February 2017
Source:Medical Image Analysis
Author(s): Changfa Shi, Yuanzhi Cheng, Jinke Wang, Yadong Wang, Kensaku Mori, Shinichi Tamura
One major limiting factor that prevents the accurate delineation of human organs has been the presence of severe pathology and pathology affecting organ borders. Overcoming these limitations is exactly what we are concerned in this study. We propose an automatic method for accurate and robust pathological organ segmentation from CT images. The method is grounded in the active shape model (ASM) framework. It leverages techniques from low-rank and sparse decomposition (LRSD) theory to robustly recover a subspace from grossly corrupted data. We first present a population-specific LRSD-based shape prior model, called LRSD-SM, to handle non-Gaussian gross errors caused by weak and misleading appearance cues of large lesions, complex shape variations, and poor adaptation to the finer local details in a unified framework. For the shape model initialization, we introduce a method based on patient-specific LRSD-based probabilistic atlas (PA), called LRSD-PA, to deal with large errors in atlas-to-target registration and low likelihood of the target organ. Furthermore, to make our segmentation framework more efficient and robust against local minima, we develop a hierarchical ASM search strategy. Our method is tested on the SLIVER07 database for liver segmentation competition, and ranks 3rd in all the published state-of-the-art automatic methods. Our method is also evaluated on some pathological organs (pathological liver and right lung) from 95 clinical CT scans and its results are compared with the three closely related methods. The applicability of the proposed method to segmentation of the various pathological organs (including some highly severe cases) is demonstrated with good results on both quantitative and qualitative experimentation; our segmentation algorithm can delineate organ boundaries that reach a level of accuracy comparable with those of human raters.

Graphical abstract

http://ift.tt/2mnBcS0

Editorial Board

http://ift.tt/2lI1a5S

EACMFS Prizes and Awards

The Council of EACMFS wishes to ensure that all members of the Association are aware of the current awards and prizes that are available. These are designed to provide educational support and also to allow the opportunity for trainees and those who have recently achieved specialist status to visit units outside their own departments.

http://ift.tt/2lbaSKN

Announcements

Dear Colleagues,

http://ift.tt/2lI1oK7

Contemporary management of carotid blowout syndrome utilizing endovascular techniques.

http:--media.wiley.com-assets-7315-19-Wi

Contemporary management of carotid blowout syndrome utilizing endovascular techniques.

Laryngoscope. 2017 Feb;127(2):383-390

Authors: Manzoor NF, Rezaee RP, Ray A, Wick CC, Blackham K, Stepnick D, Lavertu P, Zender CA

Abstract
OBJECTIVES/HYPOTHESIS: To illustrate complex interdisciplinary decision making and the utility of modern endovascular techniques in the management of patients with carotid blowout syndrome (CBS).
STUDY DESIGNS: Retrospective chart review.
METHODS: Patients treated with endovascular strategies and/or surgical modalities were included. Control of hemorrhage, neurological, and survival outcomes were studied.
RESULTS: Between 2004 and 2014, 33 patients had 38 hemorrhagic events related to head and neck cancer that were managed with endovascular means. Of these, 23 were localized to the external carotid artery (ECA) branches and five localized to the ECA main trunk; nine were related to the common carotid artery (CCA) or internal carotid artery (ICA), and one event was related to the innominate artery. Seven events related to the CCA/ICA or innominate artery were managed with endovascular sacrifice, whereas three cases were managed with a flow-preserving approach (covered stent). Only one patient developed permanent hemiparesis. In two of the three cases where the flow-preserving approach was used, the covered stent eventually became exposed via the overlying soft tissue defect, and definitive management using carotid revascularization or resection was employed to prevent further hemorrhage. In cases of soft tissue necrosis, vascularized tissues were used to cover the great vessels as applicable.
CONCLUSIONS: The use of modern endovascular approaches for management of acute CBS yields optimal results and should be employed in a coordinated manner by the head and neck surgeon and the neurointerventionalist.
LEVEL OF EVIDENCE: 4. Laryngoscope, 2016 127:383-390, 2017.

PMID: 27900766 [PubMed - in process]

http://ift.tt/2lxGFXy

Carotid blowout syndrome in patients treated by larynx cancer.

http:--linkinghub.elsevier.com-ihub-imag

Carotid blowout syndrome in patients treated by larynx cancer.

Braz J Otorhinolaryngol. 2016 Sep 29;:

Authors: Chiesa Estomba CM, Betances Reinoso FA, Osorio Velasquez A, Castro Macia O, Gonzalez Cortés MJ, Araujo Nores J

Abstract
INTRODUCTION: Carotid blowout syndrome is an uncommon complication for patient treated by head and neck tumours, related with a high mortality rate.
OBJECTIVE: The aim of this study was to study the risk of carotid blowout in a large cohort of patients treated only by larynx cancer.
METHODS: Retrospective analysis of patients older than 18 years, treated by larynx cancer who developed a carotid blowout syndrome in a tertiary academic centre.
RESULTS: 197 patients met the inclusion criteria, 192 (98.4%) were male and 5 (1.6%) were female. 6 (3%) patients developed a carotid blowout syndrome, 4 patients had a carotid blowout syndrome located in the internal carotid artery and 2 in the common carotid artery. According to the type of rupture, 3 patients suffer a type I, 2 patients a type III and 1 patient a type II. Five of those patients had previously undergone radiotherapy and all patients underwent total laryngectomy. We found a statistical correlation between open surgical procedures (p=0.004) and radiotherapy (p=0.023) and the development of a carotid blowout syndrome.
CONCLUSION: Carotid blowout syndrome is an uncommon complication in patients treated by larynx tumours. According to our results, patient underwent radiotherapy and patients treated with open surgical procedures with pharyngeal opening have a major risk to develop this kind of complication.

PMID: 27789194 [PubMed - as supplied by publisher]

http://ift.tt/2enIPV9

Carotid blowout syndrome after nasopharyngeal carcinoma radiotherapy: successful treatment by internal carotid artery occlusion after stent implantation failure.

http:--production.springer.de-OnlineReso

Carotid blowout syndrome after nasopharyngeal carcinoma radiotherapy: successful treatment by internal carotid artery occlusion after stent implantation failure.

Springerplus. 2016;5(1):1553

Authors: Dong F, Li Q, Wu J, Zhang M, Zhang G, Li B, Jin K, Min J, Liang W, Chao M

Abstract
INTRODUCTION: Carotid blowout syndrome (CBS) secondary to radiation therapy is life-threatening and requires emergency treatment. More recently, endovascular treatment has provided an effective way to control CBS-related bleeding.
CASE DESCRIPTION: We present a case of CBS with a rupture of the internal carotid artery (ICA) pseudo-aneurysm after Gamma Knife radiation therapy for nasopharyngeal carcinoma (NPC). The patient was a 55-year-old man who was transferred to our hospital with severe repetitive epistaxis. He had a history of NPC and had been treated with Gamma Knife radiation therapy 7 months prior, with a central dose of 32 Gy and marginal dose of 16 Gy. As CBS was confirmed by angiography, and the affected part of the ICA lumen exhibited moderate stenosis, the patient was successfully treated by ICA occlusion after stent implantation failure. The patient died 40 months after this operation from tumor recurrence, but without epistaxis during follow up.
DISCUSSION AND EVALUATION: Quick selection of an appropriate treatment method is very important for an acute CBS patient.
CONCLUSION: ICA occlusion can be directly considered for an acute CBS patient, if the affected ICA exhibits stenosis that is moderate or above.

PMID: 27652126 [PubMed]

http://ift.tt/2lxPkce

Stereotactic Body Radiation Therapy for Recurrent Head and Neck Cancer.

http:--pt.wkhealth.com-pt-pt-core-templa

Stereotactic Body Radiation Therapy for Recurrent Head and Neck Cancer.

Cancer J. 2016 Jul-Aug;22(4):302-6

Authors: Ling DC, Vargo JA, Heron DE

Abstract
Stereotactic body radiation therapy (SBRT) offers a promising opportunity for cure and/or palliation to patients with recurrent head and neck cancer whose comorbidities, performance status, and history of prior treatment may preclude many other salvage options. Stereotactic body radiation therapy appears to have a favorable response and toxicity profile compared with other nonoperative salvage options for recurrent head and neck cancer. However, the risk of severe toxicity remains, with carotid blowout syndrome a unique concern, although the incidence of this complication may be minimized with alternating-day fractionation. The short overall treatment time and low rates of acute toxicity make SBRT an optimal vehicle to integrate with novel systemic therapies, and several phase II studies have used concurrent cetuximab as a radiosensitizer with SBRT with promising results. Ongoing studies aim to evaluate the potential synergistic effect of SBRT with immune checkpoint inhibitors in recurrent head and neck cancer.

PMID: 27441751 [PubMed - in process]

http://ift.tt/2lxDK0N

Anesthetic Management During Emergency Surgical Ligation for Carotid Blowout Syndrome.

Anesthetic Management During Emergency Surgical Ligation for Carotid Blowout Syndrome.

A A Case Rep. 2016 Aug 15;7(4):85-8

Authors: Klein Nulent CG, de Graaff HJ, Ketelaars R, Sewnaik A, Maissan IM

Abstract
A 44-year-old man presented to our emergency department with a pharyngeal hemorrhage, 6 weeks after a total laryngectomy and extensive neck dissection. Immediate surgical intervention was necessary to stop massive arterial hemorrhage from the pharynx. The head and neck surgeon successfully ligated the common carotid artery during this procedure. We describe the anesthetic strategy and the thromboelastometry (ROTEM®)-guided massive transfusion protocol.

PMID: 27310900 [PubMed - indexed for MEDLINE]

http://ift.tt/2lNwVuN

A limited thoracocervical approach for accessing the anterior mediastinum in retrosternal goiters: Surgical technique and implications for the management of head and neck emergencies.

A limited thoracocervical approach for accessing the anterior mediastinum in retrosternal goiters: Surgical technique and implications for the management of head and neck emergencies.

Ear Nose Throat J. 2016 Mar;95(3):E39-43

Authors: Vlastarakos PV, Trinidade A, Jaberoo MC, Mochloulis G

Abstract
In this article we describe the surgical management of retrosternal goiters via a limited thoracocervical approach, and we explore how the respective surgical know-how can be used in the management of the carotid blowout syndrome. Four cases involving patients who had undergone thyroidectomy via a limited thoracocervical approach are retrospectively reviewed. An acute blowout of the innominate artery managed with the same principal surgical technique is also reviewed. Three patients had a total thyroidectomy and one had a hemithyroidectomy. No malignancy was found. There was no mortality or unexpected morbidity from the limited thoracocervical approach. The median length of the inpatient stay was 3 days. The blowout survivor lived for 9 months, with no rebleeding and with an acceptable quality of life. We conclude that a limited thoracocervical approach can be safely performed by head and neck surgeons for accessing the anterior mediastinum in retrosternal goiters, and the respective surgical know-how can be used in the immediate management of an acute carotid blowout syndrome with satisfying long-term results and provision of quality end-of-life care.

PMID: 26991229 [PubMed - indexed for MEDLINE]

http://ift.tt/2lxVCZE

Timely Antecedent CT or MRI Can Help Predict Hemorrhage Site of Posttreatment Head and Neck Cancer, With Digital Subtraction Angiography Used as the Reference Standard.

Timely Antecedent CT or MRI Can Help Predict Hemorrhage Site of Posttreatment Head and Neck Cancer, With Digital Subtraction Angiography Used as the Reference Standard.

AJR Am J Roentgenol. 2016 Apr;206(4):829-36

Authors: Ku YK, Wong YC, Fu CJ, Tseng HJ, Wang LJ, Wang CJ, Chin SC

Abstract
OBJECTIVE: We investigated the timing of CT and MRI performed before digital subtraction angiography (DSA) in the prediction of hemorrhage sites in patients with head and neck cancers who present with acute oral or neck bleeding after receiving treatment.
MATERIALS AND METHODS: A total of 123 DSA examinations that evaluated 123 oral or neck bleeding events in 85 patients were analyzed. The last CT or MRI examinations performed within a time frame of 0-337 days before transarterial embolization were reviewed retrospectively, with three findings (pseudoaneurysm, air-containing necrotic tissue, and residual tumor) used to predict hemorrhage sites. DSA findings of pseudoaneurysm or active contrast extravasation were used as a reference standard. The sensitivity of CT and MRI for correctly predicting hemorrhage sites was used to determine the optimal timing of CT or MRI examinations performed before DSA.
RESULTS: A total of 8.9% of the DSA examinations (11/123) had equivocal findings but were followed by another bleeding event for which DSA findings were positive. CT or MRI was statistically significantly better at predicting hemorrhage sites in patients with bleeding events associated with nonhypopharyngeal cancers (p = 0.019) than in those with bleeding events associated with hypopharyngeal cancers. The sensitivity of CT or MRI in the prediction of hemorrhage sites was statistically significantly higher for the common carotid artery and the internal carotid artery when CT or MRI was performed less than 30 days before bleeding events occurred. Prediction of hemorrhagic sites was better with the use of CT angiography than with the use of enhanced CT or MRI, although it was not statistically significant.
CONCLUSION: DSA findings can temporarily be equivocal. CT or MRI examinations performed within 30 days of bleeding events can predict the site of hemorrhage. If no CT or MRI findings from the past 30 days are available, we suggest performing emergent CT angiography for the sake of obtaining better arterial detail.

PMID: 26959959 [PubMed - indexed for MEDLINE]

http://ift.tt/2lxWhKr

A novel approach to the management of carotid blowout syndrome: the use of thrombin in a case of failed covered stenting.

A novel approach to the management of carotid blowout syndrome: the use of thrombin in a case of failed covered stenting.

J Neurointerv Surg. 2016 Mar 01;:

Authors: Sablani N, Jain G, Hasan MM, Sivakumar K, Feuerwerker S, Arcot K, Farkas J

Abstract
Acute hemorrhage relating to an expanding pseudoaneurysm of the carotid artery is referred to as carotid blowout syndrome (CBS). CBS is associated with a high morbidity and mortality. We describe the case of a patient who presented with dysphagia and a pulsatile mass in the neck. Imaging revealed a pseudoaneurysm originating from the bifurcation of the distal right common carotid artery. On neuroangiography the patient lacked sufficient collaterals to allow for vessel sacrifice. A decision was made to use covered stents to prevent flow into the pseudoaneurysm while maintaining vessel patency. Despite placement of multiple covered stents there was residual slow filling of the pseudoaneurysm. We augmented this therapy with direct percutaneous thrombin injection into the pseudoaneurysm. This resulted in complete thrombosis of the pseudoaneurysm. For recalcitrant lesions in which the usual methods of stopping blood flow to the pseudoaneurysmal sac fail, an adjuvant approach with thrombin should be considered.

PMID: 26932800 [PubMed - as supplied by publisher]

http://ift.tt/2lxRcSo

Postprandial dysmetabolism: assessment and treatment.

Postprandial dysmetabolism: assessment and treatment.

Hormones (Athens). 2016 Oct;15(4):404-412

Authors: Katsiki N, Kolovou G

PMID: 28222411 [PubMed - in process]

http://ift.tt/2lNregn

Preoperative markers in differentiated thyroid cancer.

Preoperative markers in differentiated thyroid cancer.

Hormones (Athens). 2016 Oct;15(4):568-569

Authors: Chrisoulidou A

PMID: 28222419 [PubMed - in process]

http://ift.tt/2lnwPJ0

Outcomes of interventions for carotid blowout syndrome in patients with head and neck cancer.

Outcomes of interventions for carotid blowout syndrome in patients with head and neck cancer.

J Vasc Surg. 2016 Jun;63(6):1525-30

Authors: Liang NL, Guedes BD, Duvvuri U, Singh MJ, Chaer RA, Makaroun MS, Sachdev U

Abstract
BACKGROUND: The purpose of this study was to examine outcomes of a patient cohort undergoing intervention for carotid blowout syndrome associated with head and neck cancer.
METHODS: Patients with head and neck cancer who presented with carotid distribution bleeding from 2000 to 2014 were identified in the medical record. Primary outcomes were short- and midterm mortality and recurrent bleeding. Standard statistical methods and survival analysis were used to analyze study population characteristics and outcomes.
RESULTS: Thirty-seven patients were included in the study. The mean age was 60.1 ± 11.4 years (74% male). All malignancies were squamous cell type, stage IV, in a variety of primary locations: 32% oral cavity, 24% larynx, 16% superficial neck, with the remainder in the oropharynx, nasopharynx, and hypopharynx. Fifty-one percent of bleeds were of common carotid, 29% external carotid, and 19% internal carotid origin. Among the patients, 68% presented with acute hemorrhage, 24% with impending bleed, and 8% with threatened bleed. All patients underwent intervention: 38% received endovascular coil embolization, 30% stent grafts, 22% surgical ligation, and 10% primary vessel repair or bypass grafting. Although major complications were rare, 10.8% of patients had perioperative stroke. Sixteen recurrent bleeding episodes involving 12 arteries occurred in 11 patients (29.73%). Median rebleeding time was 7 days (interquartile range, 6-49). Estimated recurrent bleeding risk at 30 days and 6 months was 24% and 34%, respectively. Of the patients, 91.9% survived to hospital discharge. The 90-day and 1-year estimated survivals were 60.9% and 36.6%, respectively.
CONCLUSIONS: Carotid blowout syndrome associated with head and neck cancer carries poor mid- and long-term prognoses; however, mortality may be related more to the advanced stage of disease rather than carotid involvement or associated intervention. Both surgical and endovascular approaches may be efficacious in cases of acute hemorrhage but carry a significant risk of periprocedural stroke and recurrent bleeding.

PMID: 26926937 [PubMed - in process]

http://ift.tt/2lNyPv6

Preoperative markers in differentiated thyroid cancer.

Preoperative markers in differentiated thyroid cancer.

Hormones (Athens). 2016 Oct;15(4):568-569

Authors: Chrisoulidou A

PMID: 28222419 [PubMed - in process]

http://ift.tt/2lnwPJ0

Defining optimal vitamin D cut-off levels: Τhe role of parathyroid hormone concentrations.

Defining optimal vitamin D cut-off levels: Τhe role of parathyroid hormone concentrations.

Hormones (Athens). 2016 Oct;15(4):565-567

Authors: Karras SN, Grant WB, Naughton DP, Kotsa K

PMID: 28222418 [PubMed - in process]

http://ift.tt/2lNqNm6

Emerging treatment modalities for advanced pancreatic neuroendocrine tumors.

Emerging treatment modalities for advanced pancreatic neuroendocrine tumors.

Hormones (Athens). 2016 Oct;15(4):563-564

Authors: Sindoni A, Famà F, Gioffre-Florio M, Baldari S

PMID: 28222417 [PubMed - in process]

http://ift.tt/2lNrfAX

Calcium homeostasis in women with non-metastatic breast cancer with osteoporosis after a single dose of denosumab: a pilot study.

Calcium homeostasis in women with non-metastatic breast cancer with osteoporosis after a single dose of denosumab: a pilot study.

Hormones (Athens). 2016 Oct;15(4):560-562

Authors: Toulis K, Iliadou P, Mandanas S, Kazila P, Margaritidou E, Georgopoulos K, Pazaitou-Panayiotou K

PMID: 28222416 [PubMed - in process]

http://ift.tt/2lNx01z

Young adult patient with headache, fever and blurred vision.

Young adult patient with headache, fever and blurred vision.

Hormones (Athens). 2016 Oct;15(4):548-550

Authors: Paschou SA, Tzioras K, Trianti V, Lyra S, Lioutas VA, Seretis A, Vryonidou A

Abstract
BACKGROUND AND IMPORTANCE: This case highlights the fact that acute pituitary apoplexy may be misdiagnosed due to being confused with other entities exhibiting similar symptoms, such as meningitis or subarachnoid hemorrhage.
CLINICAL PRESENTATION: A patient in his late 30s presented with sudden and severe frontal headache, fever, blurred vision, nausea, confusion, as well as oculomotor palsy (CN III) with partial ptosis of the left eyelid, dilated left pupil and left eye globe deviation inferiorly and laterally. The final diagnosis was acute pituitary apoplexy complicating a pituitary macroadenoma. In this setting, headache is usually present due to stretching and irritation of the dura mater, and fever due to meningeal irritation or upward expansion leading to hypothalamic dysfunction. Decreased visual acuity and defects in visual fields are caused by upward expansion, which compresses the optic chiasm. Ophthalmoplegia can also be observed due to lateral expansion with invasion of the cavernous sinus.
CONCLUSION: Medical professionals involved in emergency care should be aware of this clinical entity and collaborate with endocrinologists using a multidisciplinary team approach for prompt diagnosis and optimal treatment of such patients.

PMID: 28222415 [PubMed - in process]

http://ift.tt/2lNm444

Urinary steroid metabolites in a case of florid Ectopic Cushing's syndrome and clinical correlations.

Urinary steroid metabolites in a case of florid Ectopic Cushing's syndrome and clinical correlations.

Hormones (Athens). 2016 Oct;15(4):540-547

Authors: Kyriacou A, Stepien KG, Issa B

Abstract
A 51-year old woman was admitted with multiple cerebral, pulmonary and intra-abdominal abscesses. The combination of apparent immunosuppression, obesity, diabetes mellitus, hypertension, hypokalaemia, osteoporotic fractures and bilateral shoulder avascular necrosis led to a clinical diagnosis of Cushing's syndrome (CS). This was biochemically confirmed as follows: midnight serum cortisol 4275 nmol/L (60-250), non-suppressed overnight dexamethasone suppression test, raised salivary cortisol 716 nmol/L (5-46) and ACTH 639 ng/L (0-46). Urinary free cortisol was elevated >75,000 nmol/L (<165). Urinary steroid metabolites measured by Gas Chromatography Mass Spectrometry were markedly increased: tetrahydrocortisol (THF) 219024 µg/24h and tetrahydrocortisone (THE) 88848 µg/24h. The (THF+5αTHF)/(THE) ratio was 2.8 (≤1). Pituitary MRI was unremarkable and whole body CT scanning showed a thymic tumour and bilateral adrenal hyperplasia. Urinary 5HIAA was marginally raised with a normal chromogranin A. She underwent a thymectomy which confirmed a 'paraganglioid' variant of a thymic carcinoid tumour. We describe a case of ACTH-secreting thymic carcinoid that presented with florid clinical and biochemical features of CS, but no carcinoid syndrome. The (THF+5αTHF)/(THE) ratio is reported to be a useful indicator in differentiating the aetiologies of CS, although this was not the case in our patient. In this article we examine the degree to which the various urinary steroid metabolites were raised in this patient with florid CS and compare them with some normative data obtained from patients with either Cushing's disease or the normal population. We hereby postulate that steroid metabolomics profiling may be helpful in establishing the differential diagnosis of CS.

PMID: 28222414 [PubMed - in process]

http://ift.tt/2lnDl2H

A new TRβ mutation in resistance to thyroid hormone syndrome.

A new TRβ mutation in resistance to thyroid hormone syndrome.

Hormones (Athens). 2016 Oct;15(4):534-539

Authors: Neamţu C, Ţupea C, Păun D, Hoisescu A, Ghemigian A, Refetoff S, Sriphrapradang C

Abstract
Thyroid hormones (TH) exert their actions by binding nuclear receptors alpha (TRα1) and beta (TRß1 and TRß2). Resistance to thyroid hormone (RTH) is a clinical syndrome with various clinical manifestations, its hallmark being decreased tissue sensitivity to the action of thyroid hormones. We report the case of a family harbouring a novel TRß mutation. Sequencing of the TRβ gene revealed a single nucleotide substitution-C to G in codon 340: glutamine was replaced by glutamic acid. The clinical picture and biochemical and hormonal panel showed significant differences within the family, despite their sharing the same mutation. We also present the result of low-dose antithyroid treatment in one member of the family diagnosed with this rare condition.

PMID: 28222413 [PubMed - in process]

http://ift.tt/2lI7ZEz

Low-risk papillary thyroid carcinoma patients who underwent near-total thyroidectomy without prophylactic central compartment lymph node dissection and were ablated with low-dose 50mCi RAI had excellent 10-year prognosis.

Low-risk papillary thyroid carcinoma patients who underwent near-total thyroidectomy without prophylactic central compartment lymph node dissection and were ablated with low-dose 50mCi RAI had excellent 10-year prognosis.

Hormones (Athens). 2016 Oct;15(4):511-517

Authors: Michalaki M, Bountouris P, Roupas ND, Theodoropoulou A, Agalianou N, Alexandrides T, Markou K

Abstract
BACKGROUND: The current trend in the management of low risk differentiated thyroid carcinoma is to follow less aggressive strategies.
OBJECTIVE: To assess the long-term morbidity and mortality outcomes of low-risk papillary thyroid carcinoma (PTC) patients undergoing minimal intervention.
DESIGN: We retrospectively analyzed 137 patients with low-risk PTC (stage I: n=77; stage II: n=60). Of these patients, 107 (Group 1) had macro-PTC and underwent near-total thyroidectomy and received postoperatively 50mCi RAI. The remaining 30 patients (Group 2) had micro-PTC (<1cm) and were treated only by means of near-total thyroidectomy.
RESULTS: The median follow-up for Group 1 patients was 10 years (range: 3-30). At 1-year evaluation, 8 patients of Group 1 had indeterminate or incomplete biochemical response, of whom 4 had also incomplete structural response to initial therapy. Only 1 of 4 patients with structural incomplete response underwent cervical lymph node dissection and then received an additional dose of 100mCi RAI. The remaining 7 patients received only an additional dose of 100mCi RAI. These patients have been continuously followed till the present time with no recurrences or deaths (median follow-up: 17.5 years; 3-30 years). At 15 years, 2 patients of Group 1 experienced biochemical recurrence and they received 100mCi RAI. Three patients of Group 2 experienced recurrence, with 2 receiving 50mCi RAI and 1 undergoing cervical lymph node dissection with 50mCi RAI.
CONCLUSIONS: Patients with low-risk macro-PTC treated by means of near-total thyroidectomy without PCCLND and receiving postoperatively a low dose of 50mCi RAI have excellent long-term prognosis.

PMID: 28222412 [PubMed - in process]

http://ift.tt/2lI6O8a

A novel approach to the management of carotid blowout syndrome: the use of thrombin in a case of failed covered stenting.

A novel approach to the management of carotid blowout syndrome: the use of thrombin in a case of failed covered stenting.

BMJ Case Rep. 2016 Feb 24;2016:

Authors: Sablani N, Jain G, Hasan MM, Sivakumar K, Feuerwerker S, Arcot K, Farkas J

PMID: 26912762 [PubMed - indexed for MEDLINE]

http://ift.tt/2lxPAIv

The depiction of acromegaly in ancient Greek and Hellenistic art.

The depiction of acromegaly in ancient Greek and Hellenistic art.

Hormones (Athens). 2016 Oct;15(4):570-571

Authors: Laios K, Zozolou M, Markatos K, Karamanou M, Androutsos G

PMID: 28222410 [PubMed - in process]

http://ift.tt/2lNrqwa

A novel mutation of the calcium-sensing receptor gene in a German subject with familial hypocalciuric hypercalcemia and primary hyperparathyroidism.

A novel mutation of the calcium-sensing receptor gene in a German subject with familial hypocalciuric hypercalcemia and primary hyperparathyroidism.

Hormones (Athens). 2016 Oct;15(4):557-559

Authors: Papadakis M, Meurer N, Margariti T, Meyer A, Weyerbrock N, Dotzenrath C

Abstract
OBJECTIVE: The coexistence of familial hypocalciuric hypercalcemia (FHH) and primary hyperparathyroidism (PHPT) is extremely rare. Genetic evidence has demonstrated a causal relationship between FHH and the presence of inactivating mutations in the calcium-sensing receptor gene.
METHOD: We herein report a 60-year-old German patient who was referred for hypercalcemia and increased PTH levels found incidentally during normal routine blood tests.
RESULTS: The patient underwent surgical exploration and the diagnosis of PHPT was histologically confirmed. One week later, the follow-up blood tests revealed recurrent hypercalcemia, and the possibility of FHH was reconsidered. Genetic analysis was performed and revealed a novel heterozygous CaSR single missense mutation (Arg551Gly) within the extracellular CaSR domain.
CONCLUSION: We report a novel heterozygous missense inactivating mutation within the extracellular CaSR domain in a German subject with FHH and histologically proven PHPT.

PMID: 28222409 [PubMed - in process]

http://ift.tt/2lNwY9I

Severe osteoporosis with multiple spontaneous vertebral fractures in a young male carrying triple polymorphisms in the vitamin D receptor, collagen type 1, and low-density lipoprotein receptor-related peptide 5 genes.

Severe osteoporosis with multiple spontaneous vertebral fractures in a young male carrying triple polymorphisms in the vitamin D receptor, collagen type 1, and low-density lipoprotein receptor-related peptide 5 genes.

Hormones (Athens). 2016 Oct;15(4):551-556

Authors: Yavropoulou MP, Kollia P, Chatzidimitriou D, Samara S, Skoura L, Yovos JG

Abstract
Osteoporosis is a common disease with a strong genetic component. Several studies have reported the vitamin D receptor (VDR), collagen type I (COL1A1), and LDL receptor-related protein 5 (LRP5) genes as the most likely candidates. However, most of the studies have been carried out in postmenopausal women and older men and show inconsistent results.
CASE PRESENTATION: We report a case of a 26-year old male who presented with severe back pain of acute onset, unrelated to any kind of trauma, and diffuse myalgia. Imaging of the lumbar and the thoracic spine revealed two Grade 3, according to Genant's semiquantitative method, vertebral fractures in T10 and T11 and multiple Grade 1 and 2 fractures from T8 to L2. Measurement of bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA) (Lunar Prodigy) showed severe osteoporosis of the lumbar spine (Z-score=-3.0, BMD = 0.866 gr/cm2). A complete laboratory and biochemical work-up was performed to exclude secondary causes of osteoporosis. Total genomic DNA was extracted from peripheral blood and was used as a template for genotype analysis. The patient was heterozygous for the p.V667M mutation of the LRP5 gene and for the BsmI [g.63980 G→A, rs1544410] and Sp1 polymorphisms [g.6252 G→T, rs1800012] of the VDR and COL1A1 genes, respectively. Further genotype analysis excluded types of osteogenesis imperfecta associated with mutations in the COL1A1 and COL1A2 genes.
CONCLUSION: We herein show that the co-existence of three polymorphic sites in the VDR, COL1A1, and LPR-5 genes in a young male adult caused severe osteoporosis with multiple fractures, suggesting a combined effect and/or interaction between these genes.

PMID: 28222408 [PubMed - in process]

http://ift.tt/2lNmya1

Parathyroid hormone response to severe vitamin D deficiency is associated with femoral neck bone mineral density: an observational study of 405 women with hip-fracture.

Parathyroid hormone response to severe vitamin D deficiency is associated with femoral neck bone mineral density: an observational study of 405 women with hip-fracture.

Hormones (Athens). 2016 Oct;15(4):527-533

Authors: Di Monaco M, Castiglioni C, Tappero R

Abstract
OBJECTIVE: Hip-fracture patients with vitamin D deficiency can have either secondary hyperparathyroidism or normal levels of parathyroid hormone (PTH). We hypothesized that bone mineral density (BMD) could be lower in patients with high PTH levels than in those with normal levels of PTH, irrespectively of the severity of vitamin D depletion.
DESIGN: In this cross-sectional study, we examined 405 women who had serum 25-hydroxyvitamin D below 12ng/ml 20.0 ± 5.9 (mean ± SD) days after a hip-fracture. PTH was assessed by a chemiluminescent immunometric assay and BMD by dual-energy x-ray absorptiometry at the unfractured femoral neck.
RESULTS: BMD was significantly lower in the 148 women with secondary hyperparathyroidism than in the 257 with normal PTH levels: the mean T-score (SD) was -2.88 (0.93) and -2.65 (0.83), respectively, in the two groups (mean difference 0.23; 95% CI 0.05 - 0.41; P = 0.010). The association between PTH status and BMD persisted after adjustment for age, body mass index, phosphate, albumin-adjusted total calcium, 25-hydroxyvitamin D, estimated glomerular filtration rate, and magnesium (P=0.01). The presence of secondary hyperparathyroidism was significantly associated with a femoral neck T-score lower than -2.5. The adjusted odds ratio was 1.81 (95% CI 1.11 - 2.95; P=0.017).
CONCLUSIONS: Our results show that PTH levels in the presence of severe vitamin D deficiency were significantly associated with femoral BMD in women with hip-fracture. Prevention and treatment of vitamin D deficiency may be particularly relevant in women who develop secondary hyperparathyroidism.

PMID: 28222407 [PubMed - in process]

http://ift.tt/2lNqc3U

Leydig cell clustering and Reinke crystal distribution in relation to hormonal function in adult patients with testicular dysgenesis syndrome (TDS) including cryptorchidism.

Leydig cell clustering and Reinke crystal distribution in relation to hormonal function in adult patients with testicular dysgenesis syndrome (TDS) including cryptorchidism.

Hormones (Athens). 2016 Oct;15(4):518-526

Authors: Soerensen RR, Johannsen TH, Skakkebaek NE, Rajpert-De Meyts E

Abstract
OBJECTIVE: Testicular dysgenesis syndrome (TDS) comprises testicular germ cell cancer, cryptorchidism and some cases of male infertility and hypospadias, which can be linked to impairment of intrauterine gonadal development. Among histological signs of TDS, large Leydig cell (LC) clusters (micronodules) are frequently present. This study aimed to investigate possible associations of LC micronodules with the presence of Reinke crystals and hormonal function of LCs, the latter primarily reflected by serum concentrations of luteinising hormone (LH) and testosterone, in patients with TDS.
DESIGN: A retrospective study of 101 andrological patients with TDS (infertility with and without a history of cryptorchidism or presence of germ cell neoplasia in situ) and 20 controls with normal testis histology and LC-function. Archived testicular biopsies were re-evaluated for the presence of LC micronodules and Reinke crystals and the findings were correlated with testis size and serum concentrations of LH, follicle-stimulating hormone (FSH), testosterone, inhibin B, estradiol and sex hormone binding globulin (SHBG).
RESULTS: TDS patients with bilateral LC micronodules had significantly lower concentrations of LH, FSH and inhibin B, a lower testosterone/LH-ratio and smaller testis sizes compared to TDS-patients lacking this feature. Presence of LC micronodules was correlated with a lower number of Reinke crystals, while cryptorchid testes had a significantly higher number of crystals than normally descended TDS testes.
CONCLUSION: LC micronodules appear to be a compensatory mechanism caused by androgenic failure and are presumably driven by high concentrations of LH. A relative paucity of Reinke crystals in LCs within micronodules in normally descended TDS testes may be a feature of recently renewed immature Leydig cells. The increased number of Reinke crystals in LCs in testes that were either undescended at birth or are persistently undescended could indicate an impairment of LC renewal in cryptorchidism.

PMID: 28222406 [PubMed - in process]

http://ift.tt/2lNAEbF

Thyroid hormones: a potential ally to LDL-cholesterol-lowering agents.

Thyroid hormones: a potential ally to LDL-cholesterol-lowering agents.

Hormones (Athens). 2016 Oct;15(4):500-510

Authors: Duntas LN, Brenta G

Abstract
L-thyroxine (LT4) treatment of hypothyroidism, particularly in patients with thyroid- stimulating hormone (TSH) >10mU/L, results in improved lipid profile, as LT4 stimulates low-density lipoprotein cholesterol (LDL-C) degradation and the conversion of cholesterol in bile acids by inducing LDL-receptor and 7 alpha hydroxylase expression, respectively. Statins decrease total cholesterol (TC) and LDL-C mainly by suppressing 3-hydroxy-3-methylglutaryl coenzyme A activity. Therefore, the addition of statins to LT4 treatment, following the reversal of hypothyroidism, acts synergistically and forms a powerful treatment modality in patients with this condition whose serum lipids have not achieved the target. Statin add-on therapies, such as ezetimibe (EZE) and the recently approved proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, in conjunction with LT4 therapy, produce an even more favorable profile. Ezetimibe blocks the intestinal absorption of cholesterol, while in patients with heterozygous familiar hyperlipidemia, PCSK9 inhibitors suppress PCSK9, thereby promoting LDL-C degradation. The synergy of these drugs results in a far better lipidemic profile than when each drug is administered alone, with LT4 treatment clearly enhancing, in many respects, the efficacy of therapy.

PMID: 28222405 [PubMed - in process]

http://ift.tt/2lIaHKa

Glycemic control in patients with insulinoma.

Glycemic control in patients with insulinoma.

Hormones (Athens). 2016 Oct;15(4):489-499

Authors: Matej A, Bujwid H, Wroński J

Abstract
Insulinoma is the most common neuroendocrine tumor of the pancreas. Surgical management of insulinomas is considered to be the only curative method. However, effective glycemic control preoperatively and in unresectable insulinomas remains a significant issue. Hyperinsulinism, occurring as a result of the hormone-secreting tumor, leads to life-threatening hypoglycemia episodes which require urgent medical treatment. This article discusses current management of hypoglycemia in insulinoma patients, including: education and lifestyle modifications, pharmacotherapy (diazoxide, somatostatin analogs, mTOR inhibitor - everolimus), cytoreductive methods and continuous glucose monitoring systems.

PMID: 28222404 [PubMed - in process]

http://ift.tt/2lNwWP8

Muscular effects of vitamin D in young athletes and non-athletes and in the elderly.

Muscular effects of vitamin D in young athletes and non-athletes and in the elderly.

Hormones (Athens). 2016 Oct;15(4):471-488

Authors: Koundourakis NE, Avgoustinaki PD, Malliaraki N, Margioris AN

Abstract
Muscles are major targets of vitamin D. Exposure of skeletal muscles to vitamin D induces the expression of multiple myogenic transcription factors enhancing muscle cell proliferation and differentiation. At the same time vitamin D suppresses the expression of myostatin, a negative regulator of muscle mass. Moreover, vitamin D increases the number of type II or fast twitch muscle cells and in particular that of type IIA cells, while its deficiency causes type IIA cell atrophy. Furthermore, vitamin D supplementation in young males with low vitamin D levels increases the percentage of type IIA fibers in muscles, causing an increase in muscular high power output. Vitamin D levels are strongly associated with exercise performance in athletes and physically active individuals. In the elderly and in adults below the age of 65, several studies have established a close association between vitamin D levels and neuromuscular coordination. The aim of this review is to appraise our current understanding of the significance of vitamin D on muscular performance in both older and frail individuals as well as in younger adults, athletes or non-athletes with regard to both ordinary everyday musculoskeletal tasks and peak athletic performance.

PMID: 28222403 [PubMed - in process]

http://ift.tt/2lNA6m8

Prevention and Treatment of Life-Threatening Bleeding After Thyroid Surgery.

Prevention and Treatment of Life-Threatening Bleeding After Thyroid Surgery.

Med Sci Monit. 2015 Nov 27;21:3682-9

Authors: Zhang X, An C, Liu J, Li Z, Tang P, Xu Z

Abstract
BACKGROUND Few reports have discussed life- threatening bleeding that occurs postoperatively in patients who have undergone thyroid surgery. In this article, we discuss the causes, treatment measures, and possible ways of preventing this severe complication. MATERIAL AND METHODS From Jan 2002 to Dec 2014 we retrospectively analyzed 7 patients who developed life-threatening bleeding after undergoing thyroid surgery at our center. RESULTS Among the group of 7 patients, there was 1 case of superior thyroid artery hemorrhage (STAH), 5 cases of carotid blowout syndrome (CBS), and 1 case of tracheo-innominate fistula (TIF). The STAH was caused by unreliable ligation. All the cases of CBS and TIF were caused by surgical wound infection. Six patients were transferred to the operating room immediately; open surgical treatment was performed on these 6 patients. Out of these 6 patients, 1 patient did not survive the operation, and hemorrhage was successfully controlled in 3 patients. The remaining 2 patients again experienced bleeding even after undergoing open surgery. Only 1 patient developed long-term neurological complications. CONCLUSIONS Infection is the most common cause of life-threatening bleeding that occurs postoperatively in some patients who have undergone thyroid surgery. Early surgical intervention can save the lives of these patients without causing any severe neurological complications.

PMID: 26613576 [PubMed - indexed for MEDLINE]

http://ift.tt/2cWwmek

Defining optimal vitamin D cut-off levels: Τhe role of parathyroid hormone concentrations.

Defining optimal vitamin D cut-off levels: Τhe role of parathyroid hormone concentrations.

Hormones (Athens). 2016 Oct;15(4):565-567

Authors: Karras SN, Grant WB, Naughton DP, Kotsa K

PMID: 28222418 [PubMed - in process]

http://ift.tt/2lNqNm6

Emerging treatment modalities for advanced pancreatic neuroendocrine tumors.

Emerging treatment modalities for advanced pancreatic neuroendocrine tumors.

Hormones (Athens). 2016 Oct;15(4):563-564

Authors: Sindoni A, Famà F, Gioffre-Florio M, Baldari S

PMID: 28222417 [PubMed - in process]

http://ift.tt/2lNrfAX

Endovascular Management of Post-Irradiated Carotid Blowout Syndrome.

http:--journals.plos.org-plosone-resourc

Endovascular Management of Post-Irradiated Carotid Blowout Syndrome.

PLoS One. 2015;10(10):e0139821

Authors: Chang FC, Luo CB, Lirng JF, Lin CJ, Lee HJ, Wu CC, Hung SC, Guo WY

Abstract
PURPOSE: To retrospectively evaluate the clinical and technical factors related to the outcomes of endovascular management in patients with head-and-neck cancers associated with post-irradiated carotid blowout syndrome (PCBS).
MATERIALS AND METHODS: Between 2000 and 2013, 96 patients with PCBS underwent endovascular management. The 40 patients with the pathological lesions located in the external carotid artery were classified as group 1 and were treated with embolization. The other 56 patients with the pathological lesions located in the trunk of the carotid artery were divided into 2 groups as follows: group 2A comprised the 38 patients treated with embolization, and group 2B comprised the 18 patients treated with stent-graft placement. Fisher's exact test was used to examine endovascular methods, clinical severities, and postprocedural clinical diseases as predictors of outcomes.
RESULTS: Technical success and immediate hemostasis were achieved in all patients. The results according to endovascular methods (group 1 vs 2A vs 2B) were as follows: technical complication (1/40[2.5%] vs 9/38[23.7%] vs 9/18[50.0%], P = 0.0001); rebleeding (14/40[35.0%] vs 5/38[13.2%] vs 7/18[38.9%]), P = 0.0435). The results according to clinical severity (acute vs ongoing PCBS) were as follows: technical complication (15/47[31.9%] vs 4/49[8.2%], P = 0.0035); rebleeding (18/47[38.3%] vs 8/49[16.3%], P = 0.0155). The results according to post-procedural clinical disease (regressive vs progressive change) were as follows: alive (14/21[66.7%] vs 8/75[10.7%], P<0.0001); survival time (34.1±30.6[0.3-110] vs 3.6±4.0[0.07-22] months, P<0.0001).
CONCLUSION: The outcomes of endovascular management of PCBS can be improved by taking embolization as a prior way of treatment, performing endovascular intervention in slight clinical severity and aggressive management of the post-procedural clinical disease.

PMID: 26439632 [PubMed - indexed for MEDLINE]

http://ift.tt/2ly27M1

Carotid blowout and cerebral gas embolism related to bidirectional carotid-esophageal fistula: a serious complication of esophageal cancer under radiotherapy.

Carotid blowout and cerebral gas embolism related to bidirectional carotid-esophageal fistula: a serious complication of esophageal cancer under radiotherapy.

Am J Emerg Med. 2016 Mar;34(3):683.e5-6

Authors: Kuo KH, Hsu HL, Pan YJ, Huang CY

Abstract
Carotid-esophageal fistula (CEF) could be a serious complication of esophageal cancer in a patient receiving radiotherapy. We reported a 47-year-old male patient with advanced cervical esophageal cancer under radiotherapy who developed CEF with the presentations of unstable vital signs and disturbances of consciousness. Carotid-esophageal fistula-associated life-threatening conditions of carotid blowout syndrome and cerebral gas embolism were diagnosed after presentation. Subsequently, intramural dissection of esophageal and gastric walls, profound hemoperitoneum, and hypovolemic shock occurred. When a patient who had an underlying cervical esophageal cancer treated by radiotherapy develops unstable vital signs and neurological symptoms, CEF should be kept in mind in the differential diagnoses. Physicians must be alert of the associated complications of carotid blowout syndrome and cerebral gas embolism and perform timely management including decompression, fluid resuscitation, and aggressive endovascular procedure when indicated.

PMID: 26349780 [PubMed - indexed for MEDLINE]

http://ift.tt/2lxOXOM

Hyperfractionated stereotactic reirradiation for recurrent head and neck cancer.

Hyperfractionated stereotactic reirradiation for recurrent head and neck cancer.

Strahlenther Onkol. 2016 Jan;192(1):40-6

Authors: Cvek J, Knybel L, Skacelikova E, Stransky J, Matousek P, Zelenik K, Res O, Otahal B, Molenda L, Feltl D

Abstract
PURPOSE: The goal of this work was to evaluate the efficacy and toxicity of hyperfractionated stereotactic reirradiation (re-RT) as a treatment for inoperable, recurrent, or second primary head and neck squamous cell cancer (HNSCC) that is not suitable for systemic treatment.
PATIENTS AND MATERIALS: Forty patients with recurrent or second primary HNSCC were included in this study. The patients had a median gross tumor volume of 76 ml (range 14-193 ml) and a previous radiotherapy dose greater than 60 Gy. Treatment was designed to cover 95 % of the planning target volume (PTV, defined as gross tumor volume [GTV] + 3 mm to account for microscopic spreading, with no additional set-up margin) with the prescribed dose (48 Gy in 16 fractions b.i.d.). Treatment was administered twice daily with a minimum 6 h gap. Uninvolved lymph nodes were not irradiated.
RESULTS: Treatment was completed as planned for all patients (with median duration of 11 days, range 9-14 days). Acute toxicity was evaluated using the RTOG/EORTC scale. A 37 % incidence of grade 3 mucositis was observed, with recovery time of ≤ 4 weeks for all of these patients. Acute skin toxicity was never observed to be higher than grade 2. Late toxicity was also evaluated according to the RTOG/EORTC scale. Mandible radionecrosis was seen in 4 cases (10 %); however, neither carotid blowout syndrome nor other grade 4 late toxicity occurred. One-year overall survival (OS) and local progression-free survival (L-PFS) were found to be 33 and 44 %, respectively. Performance status and GTV proved to be significant prognostic factors regarding local control and survival.
CONCLUSION: Hyperfractionated stereotactic re-RT is a reasonable treatment option for patients with recurrent/second primary HNSCC who were previously exposed to high-dose irradiation and who are not candidates for systemic treatment or hypofractionation.

PMID: 26314584 [PubMed - indexed for MEDLINE]

http://ift.tt/2lNnKu9

Fatal carotid blowout syndrome after BNCT for head and neck cancers.

Fatal carotid blowout syndrome after BNCT for head and neck cancers.

Appl Radiat Isot. 2015 Dec;106:202-6

Authors: Aihara T, Hiratsuka J, Ishikawa H, Kumada H, Ohnishi K, Kamitani N, Suzuki M, Sakurai H, Harada T

Abstract
Boron neutron capture therapy (BNCT) is high linear energy transfer (LET) radiation and tumor-selective radiation that does not cause serious damage to the surrounding normal tissues. BNCT might be effective and safe in patients with inoperable, locally advanced head and neck cancers, even those that recur at previously irradiated sites. However, carotid blowout syndrome (CBS) is a lethal complication resulting from malignant invasion of the carotid artery (CA); thus, the risk of CBS should be carefully assessed in patients with risk factors for CBS after BNCT. Thirty-three patients in our institution who underwent BNCT were analyzed. Two patients developed CBS and experienced widespread skin invasion and recurrence close to the carotid artery after irradiation. Careful attention should be paid to the occurrence of CBS if the tumor is located adjacent to the carotid artery. The presence of skin invasion from recurrent lesions after irradiation is an ominous sign of CBS onset and lethal consequences.

PMID: 26282568 [PubMed - indexed for MEDLINE]

http://ift.tt/2lxLrnB

Massive Epistaxis from Internal Carotid Pseudoaneurysm during Acute Ischemic Stroke in a Patient with Nasopharyngeal Carcinoma.

Massive Epistaxis from Internal Carotid Pseudoaneurysm during Acute Ischemic Stroke in a Patient with Nasopharyngeal Carcinoma.

Acta Neurol Taiwan. 2014 Sep;23(3):113-8

Authors: Hsiao CL, Tsai YH, Lin SK

Abstract
PURPOSE: Carotid blowout syndrome due to rupture of internal carotid artery pseudoaneurysm in NPC patients with prior neck radiation is an uncommon but life-threatening complication. Concomitant carotid stenosis with ischemic stroke and carotid rupture from pseudoaneurysm is rare.
CASE REPORT: A 71-year-old man had a history of NPC treated with radiation therapy 26 years ago. He was admitted to the hospital because of minor ischemic stroke and tarry stool. The carotid duplex sonography disclosed severe stenotic lesion in the proximal right internal carotid artery. A subsequent recurrent stroke on day three associated with nasal cavity bleeding resulted in an endotracheal intubation. Another episodic of massive epistaxis occurred on day 10 caused hypovolemic shock. Pseudoaneurysm of the left internal carotid artery was found by emergent angiography and was immediately obliterated by endovascular treatment with microcoils and glue.
CONCLUSION: Carotid blowout syndrome in NPC patients during acute ischemic stroke warrants further cervical angiographic study. Endovascular treatment provides immediate hemostasis and obliteration of ICA pseudoaneurysm.

PMID: 26077184 [PubMed - indexed for MEDLINE]

http://ift.tt/2lNEbGL

Carotid blowout syndrome in pharyngeal cancer patients treated by hypofractionated stereotactic re-irradiation using CyberKnife: A multi-institutional matched-cohort analysis.

Carotid blowout syndrome in pharyngeal cancer patients treated by hypofractionated stereotactic re-irradiation using CyberKnife: A multi-institutional matched-cohort analysis.

Radiother Oncol. 2015 Apr;115(1):67-71

Authors: Yamazaki H, Ogita M, Himei K, Nakamura S, Kotsuma T, Yoshida K, Yoshioka Y

Abstract
BACKGROUND AND PURPOSE: Although reirradiation has attracted attention as a potential therapy for recurrent head and neck tumors with the advent of modern radiotherapy, severe rate toxicity such as carotid blowout syndrome (CBOS) limits its potential. The aim of this study was to identify the risk factors of CBOS after hypofractionated stereotactic radiotherapy (SBRT).
METHODS AND PATIENTS: We conducted a matched-pair design examination of pharyngeal cancer patients treated by CyberKnife reirradiation in four institutes. Twelve cases with CBOS were observed per 60 cases without CBOS cases. Prognostic factors for CBOS were analyzed and a risk classification model was constructed.
RESULTS: The median prescribed radiation dose was 30 Gy in 5 fractions with CyberKnife SBRT after 60 Gy/30 fractions of previous radiotherapy. The median duration between reirradiation and CBOS onset was 5 months (range, 0-69 months). CBOS cases showed a median survival time of 5.5 months compared to 22.8 months for non-CBOS cases (1-year survival rate, 36% vs.72%; p=0.003). Univariate analysis identified an angle of carotid invasion of >180°, the presence of ulceration, planning treatment volume, and irradiation to lymph node areas as statistically significant predisposing factors for CBOS. Only patients with carotid invasion of >180° developed CBOS (12/50, 24%), whereas no patient with tumor involvement less than a half semicircle around the carotid artery developed CBOS (0/22, 0%, p=0.03). Multivariate Cox hazard model analysis revealed that the presence of ulceration and irradiation to lymph nodes were statistically significant predisposing factors. Thus, we constructed a CBOS risk classification system: CBOS index=(summation of risk factors; carotid invasion >180°, presence of ulceration, lymph node area irradiation). This system sufficiently separated the risk groups.
CONCLUSION: The presence of ulceration and lymph node irradiation are risk factors of CBOS. The CBOS index, including carotid invasion of >180°, is useful in classifying the risk factors and determining the indications for reirradiation.

PMID: 25827266 [PubMed - indexed for MEDLINE]

http://ift.tt/2lNyHvP

Covered Stents for the Prevention and Treatment of Carotid Blowout Syndrome.

https:--academic.oup.com-images-oup_pubm

Covered Stents for the Prevention and Treatment of Carotid Blowout Syndrome.

Neurosurgery. 2015 Aug;77(2):164-7

Authors: Gaynor BG, Haussen DC, Ambekar S, Peterson EC, Yavagal DR, Elhammady MS

Abstract
BACKGROUND: Carotid blowout syndrome (CBS) is a life-threatening emergency resulting from compromise of the carotid artery caused by malignancy in the head and neck.
OBJECTIVE: To report our experience with covered stents for the prevention or treatment of carotid blowout syndrome secondary to head and neck cancer to ascertain the safety and efficacy of this technique.
METHODS: We reviewed the characteristics and outcome of all patients who underwent covered stent placement in the extracranial carotid artery in the setting of head and neck malignancy between 2006 and 2013 at the University of Miami. Patient demographics, presenting symptoms, devices used, perioperative complications, imaging, and follow-up data were reviewed.
RESULTS: Seventeen carotids in 15 patients, whose ages ranged from 20 to 84 years (mean, 70.4 years), were treated with 20 covered nitinol (Viabahn Endoprosthesis, Gore, Flagstaff, Arizona) stents. Three patients were treated acutely for bleeding from carotid blowout, and 12 were treated prophylactically for threatened carotid blowout. All patients were given periprocedural dual antiplatelet therapy. No thromboembolic or ischemic complications were noted. Hemorrhage after treatment occurred in 4 patients. In 2 patients, the hemorrhage was from a source not covered by the stent.
CONCLUSION: The use of covered stents is a simple, safe, and effective method for treating or preventing carotid blowout syndrome in patients with head and neck malignancy. Carotid artery reconstruction with covered stents may minimize the risk of ischemic complications associated with endovascular or surgical carotid sacrifice.

PMID: 25790070 [PubMed - indexed for MEDLINE]

http://ift.tt/2lxX8ee

Carotid blowout syndrome.

Carotid blowout syndrome.

Ulus Travma Acil Cerrahi Derg. 2015 Jan;21(1):68-70

Authors: Lin YS, Wang CT, Chen YT, Chen KT

Abstract
Carotid blowout syndrome refers to the rupture of the carotid artery and its branches. Carotid blowout syndrome is a dangerous medical emergency typically resulting from complications of treatments for head and neck cancer. A patient without a prior history of head or neck cancer presented to the emergency department with a painless, enlarging neck mass was reported in this study. The mass progressed to acute airway obstruction during imaging of the lesion and necessitated emergency cricothyrotomy to secure the airway. The patient underwent four endovascular treatments to manage repeated bleeding thus producing the neurological complication of right middle cerebral artery infarction. Clinical manifestations, varied treatments, and common complications of carotid blowout syndrome were discussed.

PMID: 25779716 [PubMed - indexed for MEDLINE]

http://ift.tt/2lNs5xF

Endovascular treatment of carotid artery blowout syndrome caused by oropharyngeal carcinoma.

Endovascular treatment of carotid artery blowout syndrome caused by oropharyngeal carcinoma.

Interv Neuroradiol. 2014 Jul-Aug;20(4):510-3

Authors: Ergun O, Celtikci P, Durmaz HA, Birgi E, Hekimoglu B

Abstract
A 64-year-old man was admitted with massive hemoptysis caused by oropharyngeal carcinoma. Angiography revealed active extravasation from the left carotid bulb. Covered stent-graft placement resolved the bleeding, but the patient presented with recurrent hemorrhage two hours later and was treated with another stent-graft.

PMID: 25207916 [PubMed - indexed for MEDLINE]

http://ift.tt/2lNs50D

Honokiol protects skin cells against inflammation, collagenolysis, apoptosis, and senescence caused by cigarette smoke damage

Abstract

Background

Pollution, especially cigarette smoke, is a major cause of skin damage.

Objectives

To assess the effects of the small molecule polyphenol, honokiol, on reversing cigarette smoke-induced damage in vitro to relevant skin cells.

Methods

Keratinocytes (HaCat) cultures were exposed to cigarette smoke and, after 48 hours, IL-1α and IL-8 were measured in cell supernatants. Moreover, TIMP-2 production, apoptosis rate, and senescence β-galactosidase expression were evaluated in primary human foreskin fibroblasts (HFF-1) cultures.

Results

Honokiol at 10 μm reduced IL-1α production by 3.4 folds (P < 0.05) and at 10 and 20 μm reduced IL-8 by 23.9% and 53.1% (P < 0.001), respectively, in HaCat keratinocytes. In HFF-1, honokiol restored TIMP-2 production by 96.9% and 91.9% (P < 0.001), respectively, at 10 and 20 μm, as well as reduced apoptosis by 47.1% (P < 0.001) and 41.3% (P < 0.01), respectively. Finally, honokiol reduced senescence-associated β-galactosidase expression in HFF-1.

Conclusion

Honokiol protects both HFF-1 and HaCat against cigarette smoke-induced inflammation, collagenolysis, apoptosis, and senescence.

http://ift.tt/2meG90b

Expression levels of transcription factor PU.1 and interleukin-9 in atopic dermatitis and their relation to disease severity and eruption types

Abstract

Background

The role of immunological factors in atopic dermatitis (AD) pathogenesis is well established. T-helper (TH) cells are central in AD pathogenesis. A relatively new subset of T cells, Th9 cells, was shown to be involved in the development of allergic asthma and allergic rhinitis, while its role in AD is still to be investigated. This study aimed to measure gene expression levels of interleukin-9 (IL-9) and PU.1, and to examine relationships with disease severity, serum IgE, and eruption types in AD patients.

Methods

The study enrolled 30 AD patients, 30 psoriasis patients, and 30 healthy subjects. The severity of AD was assessed using the SCORAD index. IL-9 and PU.1 expressions were measured by using real-time quantitative polymerase chain reaction (RQ-PCR). Serum IgE was measured by IgE (human) enzyme-linked immunosorbent assay (ELISA) Kit.

Results

IL-9 and PU.1 gene expressions were significantly higher in AD patients than in controls (P1 = 0.007, P2 < 0.001, respectively). In the atopic dermatitis patients, expression of IL-9 and PU.1 were significantly positively correlated with SCORAD index (P1 = 0.004, P2 = 0.002) and clinically with erythema and edema scores. IL-9 and PU.1 expressions were positively significantly correlated (P = 0.005) and positively correlated with serum IgE in the AD group (P1 = 0.017, P2 = 0.023). No significant difference was noted between AD patients with or without histories of other atopies regarding expression levels of IL-9 and PU.1 (P1 = 0.677, P2 = 0.135).

Conclusions

PU.1 and IL-9 may play a role in AD pathogenesis and relate to disease severity and clinical eruption types.

http://ift.tt/2lslOq9

Aims and Scope & Editorial Board

Publication date: January 2017
Source:Bioactive Carbohydrates and Dietary Fibre, Volume 9

http://ift.tt/2mnMjup

The Concerted Action of Type 2 and Type 3 Deiodinases Regulates the Cell Cycle and Survival of Basal Cell Carcinoma Cells

Thyroid , Vol. 0, No. 0.

http://ift.tt/2mnG9u9

Applying Criteria of Active Surveillance to Low-Risk Papillary Thyroid Cancer Over a Decade: How Many Surgeries and Complications Can Be Avoided?

Thyroid , Vol. 0, No. 0.

http://ift.tt/2kODbm2

The efficiency and adverse events of radiotherapy with cetuximab for Japanese head and neck cancer patients

Radiotherapy with cisplatin (Chemoradiotherapy, CRT) has long been one of the standard treatments for head and neck squamous cell cancer (HNSCC). Approval of cetuximab for the treatment of HNSCC has made radiotherapy with cetuximab (Bioradiotherapy, BRT) a new treatment option for HNSCC. Reports of BRT in the Japanese written in English up to now is only the phase II study, though it includes only 22 patients. Also on the nature of the clinical Phase II trial, sampling bias of cases may exist. Here we report the treatment completion rate, response rate and frequency of adverse events of BRT in Japanese patients with HNSCC in English for the first time.

http://ift.tt/2meCkIJ

Naturally-occurring fatigue and cardiovascular response to a simple memory challenge

Publication date: Available online 22 February 2017
Source:International Journal of Psychophysiology
Author(s): Christopher Mlynski, Rex A. Wright, Stephanie D. Agtarap, Juan Rojas
Participants first completed a state affect checklist that included a fatigue (energy-tiredness) index and a measure of mental sharpness. They then were presented a simple memory challenge. In the first minute of the two-minute work period, heart rate responses (1) rose with values on the fatigue index, and (2) fell with values on the measure of mental sharpness. In the second minute of the work period, the responses were unrelated to fatigue index and mental sharpness values. Follow-up analysis indicated mental sharpness mediation of fatigue influence on heart rate in Minute 1. First minute findings add substantively to the body of evidence supporting recent suggestions that fatigue can lead people to try harder and experience stronger cardiovascular responses when confronted with simple challenges. They also support the suggestion that fatigue might exert its influence on cardiovascular responses to a mental challenge by diminishing cognitive clarity, that is, by obscuring thought. Second minute findings are contrary to the fatigue suggestions, but could indicate that memorization was accomplished in the first minute. A practical implication of the first minute results is that real-world fatigue could elevate health risk by enhancing CV responses to mundane daily tasks.

http://ift.tt/2l1ONO2

Event-related theta oscillatory substrates for facilitation and interference effects of negative emotion on children's cognition

Publication date: Available online 22 February 2017
Source:International Journal of Psychophysiology
Author(s): Zhongqing Jiang, Allison C. Waters, Ying Liu, Wenhui Li, Lizhu Yang
We investigated the brain oscillatory contribution to emotion-cognition interaction in young children. Five-year-old participants (n=27) underwent EEG recording while engaged in a color identification task. Each trial began with an emotional prime. Response times indicated whether emotional primes facilitated or interfered with performance. Related effects were detected in theta-band power over parietal-occipital cortex, early in the response epoch (<500ms). Children in the emotion facilitation group showed greater theta synchronization for negative stimuli. The opposite trend was observed in the interference group. Results suggest a role for theta oscillations in children's adaptive response to emotional content in cognitive performance.

http://ift.tt/2lsfbDZ

The Concerted Action of Type 2 and Type 3 Deiodinases Regulates the Cell Cycle and Survival of Basal Cell Carcinoma Cells

Thyroid , Vol. 0, No. 0.

http://ift.tt/2mnG9u9

Applying Criteria of Active Surveillance to Low-Risk Papillary Thyroid Cancer Over a Decade: How Many Surgeries and Complications Can Be Avoided?

Thyroid , Vol. 0, No. 0.

http://ift.tt/2kODbm2

The efficiency and adverse events of radiotherapy with cetuximab for Japanese head and neck cancer patients

Over-expression of CircRNA_100876 in non-small cell lung cancer and its prognostic value

Publication date: Available online 22 February 2017
Source:Pathology - Research and Practice
Author(s): Jun-tao Yao, Qiu-ping Liu, Mo-qi Lv, Dang-xia Zhou, Zi-jun Liao, Ke-jun Nan
Circular RNAs (circRNAs) are a novel type of endogenous RNAs featuring stable structure and high tissue-specific expression. Recently, accumulating evidence has revealed that aberrant circRNAs expression plays important roles in carcinogenesis and tumor progression. However, the expression pattern and biological function of circRNAs in non small cell lung cancer (NSCLC) remain largely unknown. Therefore, the purpose of this study was to clarify the possible role of one of typical circRNAs, circRNA_100876 in NSCLC and to define its prognostic value in NSCLC. Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect the expression of circRNA_100876 in tumor tissues and their adjacent nontumorous tissues in 101 patients with NSCLC. We found that the expression level of circRNA_100876 were significantly elevated in NSCLC tissues when compared with their adjacent nontumorous tissues (P=0.000). Moreover, there was a close correlation between the circRNA_100876 up-regulation expression and lymph node metastasis (P=0.001) and tumor staging (P=0.001) in NSCLC. In addition, Kaplan-Meier survival analysis demonstrated that the overall survival time of NSCLC patients with high circRNA_100876 expression was significantly shorter than those patients with low circRNA_100876 expression (P=0.000). In conclusion, our findings indicate that circRNA_100876 is closely related to the carcinogenesis of NSCLC and it might be served as a potential prognostic biomarker and therapeutic target for NSCLC.

http://ift.tt/2lb52JB

Sensitivity of tumor surface brushings to detect human papilloma virus DNA in head and neck cancer

About 85% of adults will have a human papilloma virus (HPV) infection in their life, but not all infections transform in a carcinoma, which develops from a persistent HPV induced lesion. In most cases the infection is transient and eliminated by the immune system [1]. HPV driven and HPV independent cancer of the head and neck have a different demographic, clinical, molecular and genomic entity [2]. The prevalence of this cancer has particularly increased in North America and Europe. Men younger than 60years are frequently affected [3].

http://ift.tt/2meEVlV

Evaluation of the Effects of Photobiomodulation on Biomechanical Properties and Hounsfield Unit of Partial Osteotomy Healing in an Experimental Rat Model of Type I Diabetes and Osteoporosis

Photomedicine and Laser Surgery , Vol. 0, No. 0.

http://ift.tt/2laVuhm

Phototoxicity of Vascular Endothelial Cells Caused by Contact with Talaporfin Sodium for 15–120 Min: In Vitro and In Vivo Studies

Photomedicine and Laser Surgery , Vol. 0, No. 0.

http://ift.tt/2lHZIR1

Comparison of Three Final Irrigation Activation Techniques: Effects on Canal Cleanness, Smear Layer Removal, and Dentinal Tubule Penetration of Two Root Canal Sealers

Photomedicine and Laser Surgery , Vol. 0, No. 0.

http://ift.tt/2laKjWi

Analysis of Human Tooth Pulp Chamber Temperature After 670 nm Laser Irradiation: In Vitro Study

Photomedicine and Laser Surgery , Vol. 0, No. 0.

http://ift.tt/2lHQzYE

The multimorbid polysensitized phenotype is associated with the severity of allergic diseases

We read with great interest 3 consecutive articles recently published in the Journal.1-3

http://ift.tt/2lrWKQ2

Reply

We appreciate this correspondence from Bousquet et al1 that our study affirms the importance of the allergy multimorbid, polysensitized phenotype in childhood asthma severity. In our Inner-City Asthma Consortium's Asthma Phenotypes in the Inner City study of children with persistent asthma characterized with 1 year of guidelines-based asthma and rhinitis management, 1 phenotype, cluster E, was distinguished by high asthma severity and exacerbation rates, as well as allergic multimorbidity and polysensitization.

http://ift.tt/2lxCdaZ

Dermal morphological changes following salicylic acid peeling and microdermabrasion

Summary

Background

Microdermabrasion and chemical peeling are popular, inexpensive, and safe methods for treatment of some skin disorders and to rejuvenate skin.

Objectives

To study the alterations of the dermal connective tissue following salicylic acid peeling and microdermabrasion.

Methods

Twenty patients were participated in our study. All participants underwent facial salicylic acid 30% peel or microdermabrasion (10 cases in each group) weekly for 6 weeks. Punch biopsies were obtained from the clinically normal skin of the right postauricular region 1 week before treatment (control group). Other punch skin biopsies were obtained 1 week after the end of the treatments from the left postauricular area. This region was treated in a similar way to the adjacent lesional skin (treated group). We used routine histological techniques (H&E stain), special stains (Masson trichrome and orcein stains), and image analyzer to study the alterations of the dermal connective tissues.

Results

Our study demonstrates variations in the morphological changes between the control and the treated groups, and between chemical peels and microdermabrasion. Both salicylic acid 30% and microdermabrasion were associated with thickened epidermal layer, shallow dermal papillae, dense collagen, and elastic fibers. There was a significant increase among those treated sites vs control regarding epidermal thickness and collagen thickness. Also, there was a highly statistically significant increase among those treated with salicylic acid vs microdermabrasion regarding the epidermal, collagen, and elastin thickness.

Conclusions

Both methods stimulate the repair process. The mechanisms underlying these variations are open for further investigations.

http://ift.tt/2laU3Q9

Comparison of digital panoramic radiography versus cone beam computerized tomography for measuring alveolar bone

Abstract

Background

Cone beam computerized tomography (CBCT) has been widely used in dental implanting. However, the local hospitals usually don't have access to CBCT due to the cost and medical investment, especially in West of China. The doctors in local hospitals have to make reasonable dental planting using orthopantomography (OPG) to reduce risks. Therefore, it is clinically meaningful to determine the magnification rate of OPG to obtain correct diagnosis. This study investigated the magnification rate of OPG in measuring different maxillofacial loci compared with CBCT.

Methods

Eighty-six patients demanding dental implanting were scanned by CBCT and OPG. The vertical distance between the alveolar ridge crest of the maxillary first molar and the sinus bottom of the upper jaw, the distance between the alveolar ridge crest of the mandibular first molars and the top of nerviduct in the mandibular alveolar, and the distance between the alveolar ridge crest of the maxillary central incisors and the bottoms of the nasal cavities were measured. The horizontal distance in those loci were also measured. The distances derived from CBCT were used as reference. The distances between the two methods were compared using paired t-test. The magnification rates at these positions were calculated. The relationship between the data acquired from the two methods was analyzed Pearson correlation.

Results

The correlation coefficients (R) between the paired samples obtained from OPG and CBCT were highly related (P < 0.05) with R values varying from 0.840 and 0.959 in vertical distances and R values varying from 0.703 and 0.904 in horizontal distances. Compared with data obtained from CBCT, the mean vertical magnification rates were 11.38% and 12.95% vertically and 8.55% and 9.43% horizontally for the first molars in the right and left maxilla respectively; 7.26% and 6.35% vertically and 5.33% and 4.96% horizontally for the first molars in the right and left mandible respectively; and 5.55% and 4.84% vertically and 6.53% and 7.47% horizontally for the central incisors in the upper right and left jaws respectively.

Conclusion

The magnification rates of OPG at these teeth are different. The distances measured by OPG were highly correlated with that measured by CBCT.

http://ift.tt/2l1V8Ja

Dermal morphological changes following salicylic acid peeling and microdermabrasion

Summary

Background

Microdermabrasion and chemical peeling are popular, inexpensive, and safe methods for treatment of some skin disorders and to rejuvenate skin.

Objectives

To study the alterations of the dermal connective tissue following salicylic acid peeling and microdermabrasion.

Methods

Results

Conclusions

Both methods stimulate the repair process. The mechanisms underlying these variations are open for further investigations.

http://ift.tt/2laU3Q9

Comparison of digital panoramic radiography versus cone beam computerized tomography for measuring alveolar bone

Abstract

Background

Methods

Results

Conclusion

The magnification rates of OPG at these teeth are different. The distances measured by OPG were highly correlated with that measured by CBCT.

http://ift.tt/2l1V8Ja

Wogonin, a plant derived small molecule, exerts potent anti-inflammatory and chondroprotective effects through the activation of ROS/ERK/Nrf2 signaling pathways in human Osteoarthritis chondrocytes

Publication date: Available online 22 February 2017
Source:Free Radical Biology and Medicine
Author(s): Nazir M. Khan, Abdul Haseeb, Mohammad Y. Ansari, Pratap Devarapalli, Sara Haynie, Tariq M. Haqqi
Osteoarthritis (OA), characterized by progressive destruction of articular cartilage, is the most common form of human arthritis. Here, we evaluated the potential chondroprotective and anti-inflammatory effects of Wogonin, a naturally occurring flavonoid, in IL-1β-stimulated human OA chondrocytes and cartilage explants. Wogonin completely suppressed the expression and production of inflammatory mediators including IL-6, COX-2, PGE2, iNOS and NO in IL-1β-stimulated OA chondrocytes. Further, Wogonin exhibits potent chondroprotective potential by switching the signaling axis of matrix degradation from catabolic towards anabolic ends and inhibited the expression, production and activities of matrix degrading proteases including MMP-13, MMP-3, MMP-9, and ADAMTS-4 in OA chondrocytes, and blocked the release of s-GAG and COL2A1 in IL-1β-stimulated OA cartilage explants. Wogonin also elevated the expression of cartilage anabolic factors COL2A1 and ACAN in chondrocytes and inhibited the IL-1β-mediated depletion of COL2A1 and proteoglycan content in the matrix of cartilage explants. The suppressive effect of Wogonin was not mediated through the inhibition of MAPKs or NF-κB activation. Instead, Wogonin induced mild oxidative stress through the generation of ROS and depletion of cellular GSH, thereby modulating the cellular redox leading to the induction of Nrf2/ARE pathways through activation of ROS/ERK/Nrf2/HO-1-SOD2-NQO1-GCLC signaling axis in OA chondrocytes. Molecular docking studies revealed that Wogonin can disrupt KEAP-1/Nrf-2 interaction by directly blocking the binding site of Nrf-2 in the KEAP-1 protein. Genetic ablation of Nrf2 using specific siRNA, significantly abrogated the anti-inflammatory and chondroprotective potential of Wogonin in IL-1β-stimulated OA chondrocytes. Our data indicates that Wogonin exerts chondroprotective effects through the suppression of molecular events involved in oxidative stress, inflammation and matrix degradation in OA chondrocytes and cartilage explants. The study provides novel insights into the development of Nrf2 as a promising candidate and Wogonin as a therapeutic agent for the management of OA.

http://ift.tt/2meGikD

Single-Beam Acoustic Trapping of Red Blood Cells and Polystyrene Microspheres in Flowing Red Blood Cell Saline and Plasma Suspensions

Publication date: Available online 22 February 2017
Source:Ultrasound in Medicine & Biology
Author(s): Hsiao-Chuan Liu, Ying Li, Ruimin Chen, Hayong Jung, K. Kirk Shung
Single-beam acoustic tweezers (SBATs) represent a new technology for particle and cell trapping. The advantages of SBATs are their deep penetration into tissues, reduction of tissue damage and ease of application to in vivo studies. The use of these tools for applications in drug delivery in vivo must meet the following conditions: large penetration depth, strong trapping force and tissue safety. A reasonable penetration depth for SBATs in the development of in vivo applications was established in a previous study conducted in water with zero velocity. However, capturing objects in flowing fluid can provide more meaningful results. In this study, we investigated the capability of SBATs to trap red blood cells (RBCs) and polystyrene microspheres in flowing RBC suspensions. Two different types of RBC suspension were prepared in this work: an RBC phosphate-buffered saline (PBS) suspension and an RBC plasma suspension. The results indicated that SBATs successfully trapped RBCs and polystyrene microspheres in a flowing RBC PBS suspension with an average steady velocity of 1.6 cm/s in a 2-mm-diameter polyimide. Furthermore, SBATs were found able to trap RBCs in a flowing RBC PBS suspension at speeds as high as 7.9 cm/s in a polyimide tube, which is higher than the velocity in capillaries (0.03 cm/s) and approaches the velocity in arterioles and venules. Moreover, the results also indicated that polystyrene microspheres can be trapped in an RBC plasma suspension, where aggregation is observed. This work represents a step forward in using this tool in actual in vivo experimentation.

http://ift.tt/2l1YlIK

Computer-Based Algorithmic Determination of Muscle Movement Onset Using M-Mode Ultrasonography

Publication date: Available online 22 February 2017
Source:Ultrasound in Medicine & Biology
Author(s): Andrew J. Tweedell, Courtney A. Haynes, Matthew S. Tenan
The study purpose was to evaluate the use of computer-automated algorithms as a replacement for subjective, visual determination of muscle contraction onset using M-mode ultrasonography. Biceps and quadriceps contraction images were analyzed visually and with three different classes of algorithms: pixel standard deviation (SD), high-pass filter and Teager Kaiser energy operator transformation. Algorithmic parameters and muscle onset threshold criteria were systematically varied within each class of algorithm. Linear relationships and agreements between computed and visual muscle onset were calculated. The top algorithms were high-pass filtered with a 30 Hz cutoff frequency and 20 SD above baseline, Teager Kaiser energy operator transformation with a 1200 absolute SD above baseline and SD at 10% pixel deviation with intra-class correlation coefficients (mean difference) of 0.74 (37.7 ms), 0.80 (61.8 ms) and 0.72 (109.8 ms), respectively. The results suggest that computer automated determination using high-pass filtering is a potential objective alternative to visual determination in human movement science.

http://ift.tt/2l29j0P

Αρχειοθήκη ιστολογίου

! # Ola via Alexandros G.Sfakianakis on Inoreader

Η λίστα ιστολογίων μου

Τετάρτη 22 Φεβρουαρίου 2017

Graphical abstract

Abstract

Background

Objectives

Methods

Results

Conclusion

Abstract

Background

Methods

Results

Conclusions

Summary

Background

Objectives

Methods

Results

Conclusions

Abstract

Background

Methods

Results

Conclusion

Summary

Background

Objectives

Methods

Results

Conclusions

Abstract

Background

Methods

Results

Conclusion

Αρχειοθήκη ιστολογίου